TY - JOUR
T1 - IL-6, IL-10, sFas, granulysin and indicators of intestinal permeability as early biomarkers for a fatal outcome in COVID-19
AU - Hernández-Solis, Alejandro
AU - Güemes-González, Azmavet M.
AU - Ruiz-Gómez, Ximena
AU - Álvarez-Maldonado, Pablo
AU - Castañeda-Casimiro, Jessica
AU - Flores-López, Argelia
AU - Ramírez-Guerra, Martha Alicia
AU - Muñoz-Miranda, Omar
AU - Madera-Sandoval, Ruth L.
AU - Arriaga-Pizano, Lourdes A.
AU - Nieto-Patlán, Alejandro
AU - Estrada-Parra, Sergio
AU - Pérez-Tapia, Sonia Mayra
AU - Serafín-López, Jeanet
AU - Chacón-Salinas, Rommel
AU - Escobar-Gutiérrez, Alejandro
AU - Soria-Castro, Rodolfo
AU - Ruiz-Sánchez, Bibiana Patricia
AU - Wong-Baeza, Isabel
N1 - Publisher Copyright:
© 2022 Elsevier GmbH
PY - 2022/11
Y1 - 2022/11
N2 - The clinical presentation of coronavirus disease 2019 (COVID-19), which is caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), ranges between mild respiratory symptoms and a severe disease that shares many of the features of sepsis. Sepsis is a deregulated response to infection that causes life-threatening organ failure. During sepsis, the intestinal epithelial cells are affected, causing an increase in intestinal permeability and allowing microbial translocation from the intestine to the circulation, which exacerbates the inflammatory response. Here we studied patients with moderate, severe and critical COVID-19 by measuring a panel of molecules representative of the innate and adaptive immune responses to SARS-CoV-2, which also reflect the presence of systemic inflammation and the state of the intestinal barrier. We found that non-surviving COVID-19 patients had higher levels of low-affinity anti-RBD IgA antibodies than surviving patients, which may be a response to increased microbial translocation. We identified sFas and granulysin, in addition to IL-6 and IL-10, as possible early biomarkers with high sensitivity (>73 %) and specificity (>51 %) to discriminate between surviving and non-surviving COVID-19 patients. Finally, we found that the microbial metabolite D-lactate and the tight junction regulator zonulin were increased in the serum of patients with severe COVID-19 and in COVID-19 patients with secondary infections, suggesting that increased intestinal permeability may be a source of secondary infections in these patients. COVID-19 patients with secondary infections had higher disease severity and mortality than patients without these infections, indicating that intestinal permeability markers could provide complementary information to the serum cytokines for the early identification of COVID-19 patients with a high risk of a fatal outcome.
AB - The clinical presentation of coronavirus disease 2019 (COVID-19), which is caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), ranges between mild respiratory symptoms and a severe disease that shares many of the features of sepsis. Sepsis is a deregulated response to infection that causes life-threatening organ failure. During sepsis, the intestinal epithelial cells are affected, causing an increase in intestinal permeability and allowing microbial translocation from the intestine to the circulation, which exacerbates the inflammatory response. Here we studied patients with moderate, severe and critical COVID-19 by measuring a panel of molecules representative of the innate and adaptive immune responses to SARS-CoV-2, which also reflect the presence of systemic inflammation and the state of the intestinal barrier. We found that non-surviving COVID-19 patients had higher levels of low-affinity anti-RBD IgA antibodies than surviving patients, which may be a response to increased microbial translocation. We identified sFas and granulysin, in addition to IL-6 and IL-10, as possible early biomarkers with high sensitivity (>73 %) and specificity (>51 %) to discriminate between surviving and non-surviving COVID-19 patients. Finally, we found that the microbial metabolite D-lactate and the tight junction regulator zonulin were increased in the serum of patients with severe COVID-19 and in COVID-19 patients with secondary infections, suggesting that increased intestinal permeability may be a source of secondary infections in these patients. COVID-19 patients with secondary infections had higher disease severity and mortality than patients without these infections, indicating that intestinal permeability markers could provide complementary information to the serum cytokines for the early identification of COVID-19 patients with a high risk of a fatal outcome.
KW - COVID-19
KW - Intestinal permeability
KW - Secondary infections
KW - Sepsis
UR - http://www.scopus.com/inward/record.url?scp=85139298330&partnerID=8YFLogxK
U2 - 10.1016/j.imbio.2022.152288
DO - 10.1016/j.imbio.2022.152288
M3 - Artículo
C2 - 36209721
AN - SCOPUS:85139298330
SN - 0171-2985
VL - 227
JO - Immunobiology
JF - Immunobiology
IS - 6
M1 - 152288
ER -